Looking beyond discussions of medical and social models: A critical qualitative examination of deaf health disparities

Abstract

There is strong empirical evidence, from Australia and internationally, that people living with hearing loss or deafness experience substantial challenges to accessing health services, resulting in poor health. Despite evidence demonstrating the success of hearing technology for correcting hearing losses and deafness, health disparities between hearing people and people living with hearing loss or deafness continue. Empirical work in the area of deafness is contextualised by ongoing theoretical discussions of the medical and social models of disability and, by extension, deafness. Despite consensus among theorists, even among those who are living with a disability themselves, that the medical model is restrictive, it is clear that this model continues to shape research priorities and dominant practices and ideology in society. While social models of disability/deafness tend to be favoured among theorists and discussed as preferable to the medical model and inclusive of the lived experiences of deafness, academics continue to debate and refine the social models of deafness. These debates largely remain theoretical as there is limited empirical work that has explored how these models, and related discourses, operate within society.Located within a social constructionist framework, this thesis provides a reflexive account of how I explored ways that deafness is constructed within Australian society and how these constructions contribute to the health disparities between hearing people and people living in Australia with hearing loss or deafness. The aims of this thesis are two-fold,(1) to explore how people living with hearing loss or deafness construct experiences of deafness and how these constructs relate (if at all) to theoretical discussions of disability or deafness; (2) to examine how health professionals construct experiences of treating clients living with hearing loss or deafness. These aims are achieved in two separate studies. The first is a mixed methods study of an online forum with people living with hearing loss or iii deafness and the second, interviews with health professionals who have treated clients living with hearing loss or deafness.Chapter 1 is an outline the structure of the thesis, describing both the research problem and my position as the author. In Chapter 2, I introduce social constructionism and the tensions that exist between this framework and positivism, and how these frameworks have shaped the thesis. Building on this, I provide an overview of the research methods implemented in the thesis. In order to contextualise the research presented in this thesis, information relevant to deafness and the Australian context is discussed at length in Chapter 3. Chapter 4 and 5 are a review of the literature relevant to how deafness has been studied in the past. This review covers deafness as a socially constructed phenomenon and critiques the empirical evidence pertaining to the health-related quality of life, health knowledge and barriers to accessing health that people living with ...